The Democratic People’s Republic of Korea (DPRK), also known as North Korea, has a population of 25 million people. Hepatitis B is one of the biggest health issues in the DPRK. Although there is little reliable data, hepatitis B infection rates are estimated to be very high, affecting around 15% of the population.
When our teams started visiting the DPRK in 2015, we found there was scarce infrastructure to help people suffering from hepatitis B, with no antiviral therapy available. People with hepatitis were cared for at local “hepatitis hospitals”, however, these offered little more than rest, food and traditional herbal medicines.
The HOPE Project
The HOPE project is a program to provide life-saving hepatitis B medicines and care for the people of DPRK. HOPE was developed by Hepatitis B Free in partnership with Christian Friends of Korea, Global Care Partners and the Ministry of Public Health in DPRK. In 2016, the program began in two locations: Pyongyang (the capital of the DPRK) and Kaesong. The program provides treatment and continuous follow up of patients, alongside training for local physicians and infrastructure for hospitals, with the long-term purpose of providing a sustainable model of care for hepatitis B in the DPRK.
Antiviral therapies are life-saving medications that can prevent liver damage caused by chronic hepatitis B, including severe scarring (cirrhosis), cancer, and liver failure. These are very effective and can be taken as pills once per day. Tenofovir and entecavir are examples of these. We developed a program to provide these medications at the request of local physicians and the Ministry of Public Health. Our treatment program includes comprehensive testing and follow-up, based on WHO guidelines, identifying the patients most at need of treatment.
2) Improvements to hospital infrastructure
HOPE recognises the importance of sustainable change, and laboratory renovations including equipment and training has been made possible through the collaboration with CFK, Global Care Partners and other generous donors and volunteers. This will also enable local doctors to regularly screen and follow-up patients.
3) Regular follow-up of patients
Since the program began in 2016, teams of volunteers from Hepatitis B Free, CFK and Global Care Partners travel to the DPRK four times annually to screen new patients, and continue to follow-up those who are already on treatment. On these trips, volunteer doctors consult patients side by side with local physicians from the DPRK, allowing educational skills transfer and strengthening working relationships.
What does the future hold?
As of January 2018, over 800 patients are now being treated with hepatitis B antiviral therapy. While this still only represents a fraction of those in DPRK living with chronic hepatitis B, it is only the beginning. Both patients and physicians have expressed a sense of renewed hope and optimism, and this has positive impacts on individuals as well as their families. Both volunteers and local partners have been celebrating the small victories together.
The HOPE project aims to expand the program to other remote areas in need, as well as special demographic groups, such as prevention of hepatitis B infection passed through pregnant women to their babies.